Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $363.08 / $2,511.89	Facility		$190.55	$363.08	$2,511.89
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $870.96 / $2,187.76 / $3,019.95	Facility	25	$870.96	$2,187.76	$3,019.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $269.15 / $794.33	Professional		$173.78	$269.15	$794.33
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $190.55 / $346.74 / $1,023.29	Professional	25	$190.55	$346.74	$1,023.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $218.78 / $302.00	Professional		$177.83	$218.78	$302.00
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $194.98 / $234.42 / $346.74	Professional	25	$194.98	$234.42	$346.74
BCBS Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $1,230.27 / $1,258.93	Facility		$489.78	$1,230.27	$1,258.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $263.03 / $338.84	Professional		$239.88	$263.03	$338.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $407.38 / $489.78	Facility		$407.38	$407.38	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $309.03 / $537.03	Professional		$213.80	$309.03	$537.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $426.58 / $1,479.11	Professional		$239.88	$426.58	$1,479.11
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $269.15 / $371.54	Professional		$251.19	$269.15	$371.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $2,187.76 / $2,884.03	Facility		$1,995.26	$2,187.76	$2,884.03
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $288.40 / $446.68	Professional		$208.93	$288.40	$446.68